Clinical Epidemiology (Jun 2019)
Prevalence of high-burden medical conditions and health care resource utilization and costs among adults with cerebral palsy
Abstract
Daniel G Whitney,1,2 Neil S Kamdar,2–5 Sophia Ng,2 Edward A Hurvitz,1 Mark D Peterson1,21Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA; 2Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA; 3Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA; 4Department of Surgery, University of Michigan, Ann Arbor, MI, USA; 5Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USAPurpose: Individuals with cerebral palsy (CP) are susceptible to early development of high-burden medical conditions, which may place a considerable strain on health care resources. However, little is known about the prevalence of high-burden medical conditions or health care resource utilization among adults with CP. The purpose of this study was to determine the prevalence of high-burden medical conditions and health care resource utilization and costs among adults with CP, as compared to adults without CP.Patients and methods: Cross-sectional data from the 2016 Optum Clinformatics®, Data Mart, a de-identified nationwide claims database of beneficiaries from a single private payer in the US. ICD-10-CM diagnosis codes were used to identify all medical conditions among beneficiaries with and without CP who were between 18 and 64 years of age. Medical and outpatient pharmacy claims were used to identify annual all-cause health care resource utilization and health care costs as standardized reimbursement and patient out-of-pocket costs.Results: Adults with CP (n=5,555) had higher prevalence and odds of all medical conditions compared to adults without CP (OR=1.3–5.8; all P<0.05), except cancer (OR=1.1; 95% CI=0.9–1.3). Adults with CP had greater annual mean counts of all health care service types (eg, inpatient, emergency department) compared to adults without CP (all P<0.01). Adults with CP had higher unadjusted standardized reimbursement (mean difference=$16,288; cost ratio [CR]=3.0; 95% CI=2.9–3.1) and patient out-of-pocket (mean difference=$778; CR=1.7; 95% CI=1.6–1.7) costs compared to adults without CP. After adjusting for all prevalent medical conditions, adults with CP still had higher standardized reimbursement (CR=2.5; 95% CI=2.5–2.6) and patient out-of-pocket (CR=1.8; 95% CI=1.7–1.8) costs.Conclusion: Adults with CP have a higher prevalence of high-burden medical conditions, health care resource utilization, and health care costs compared to adults without CP. Study findings suggest the need for earlier screening strategies and preventive medical services to quell the disease and economic burden attributable to adults with CP.Keywords: cerebral palsy, epidemiology, disease, burden
